Coasting versus gnrh antagonist salvage for the prevention of ovarian hyperstimulation syndrome

AMAÇ: Çalışmanın amacı, uzun GnRH agonist protokol ile IVF-ICSI uygulaması yapılan hastalarda coasting ve GnRH an- tagonist uygulamalarının OHSS’u önlemede etkinliklerinin kar- şılaştırılmasıdır. GEREÇ VE YÖNTEM: OHSS gelişme riski yüksek olan 91 hastanın kayıtları retrospektif olarak incelenerek, coasting (n=41) ve antagonist (n=49) uygulanan hastalar, orta ve ciddi OHSS gelişimi, HCG günü estradiol düzeyleri ve IVF sonuçla- rı açısından karşılaştırıldı. BULGULAR: Orta şiddette ve ciddi OHSS gelişimi açısından gruplar arasında farklılık izlenmedi. HCG günü estradiol dü- zeyleri antagonist uygulanan grupta daha düşük bulundu, an- cak transfer edilen embriyoların kalitesinin coasting grubunda daha iyi olduğu gözlendi. Klinik gebelik oranları arasında fark yoktu. SONUÇ: Sonuçlarımız, coasting ve GnRH antagonist uygula- malarının her ikisinin de OHSS’yi önlemede etkili olduğunu göstermiştir.

Ovaryen hiperstimülasyon sendromunun önlenmesinde gnrh antagonist ve coasting uygulamalarının karşılaştırılması

OBJECTIVE: The purpose of the present study is to compare the use of GnRH antagonist salvage ver- sus coasting for the prevention of OHSS in patients undergoing IVF/ICSI cycles with long GnRH agonist protocol. STUDY DESIGN: Medical records of 91 patients (41 in coasting and 49 in GnRH antagonist group) iden- tified as at high risk of developing OHSS were reviewed retrospectively. Groups were compared for oc- currence of moderate and severe OHSS, serum estradiol on the day of HCG and IVF outcomes. RESULTS: There were no differences between the groups in terms of moderate and severe OHSS and clinical pregnancy rates. Serum estradiol levels were decreased significantly in GnRH antagonist group. Quality of the transferred embryos was better in the coasting group. CONCLUSION: Our results represent that both coasting and GnRH antagonist salvage are effective strategies to prevent OHSS in women undergoing long GnRH agonist IVF/ICSI cycles.

Kaynakça

1. International Committee for Monitoring Assisted Repro- ductive Technology, Adamson GD, de Mouzon J, Lan- caster P, Nygren KG, Sullivan E, Zegers-Hochschild F. World collaborative report on in vitro fertilization 2000. Fertil Steril 2006;85:1586-622.

2. Whelan JG 3rd, Vlahos NF. The ovarian hyperstimulation syndrome. Fertil Steril 2000;73:883-96.

3. Brinsden PR, Wada I, Tan SL, Balen A, Jacobs HS. Diag- nosis, prevention and management of ovarian hyperstimu- lation syndrome. Br J Obstet Gynaecol 1995;102:767-72.

4. Mansour R, Aboulghar M, Serour G, Amin Y, Abou-Setta AM. Criteria of a successful coasting protocol for the pre- vention of severe ovarian hyperstimulation syndrome. Hum Reprod 2005;20:3167-72.

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6. Delvigne A, Rozenberg S. Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update 2002;8:559-77.

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